Clinical Triage RN

Position Duties & Responsibilities

• Monitor assigned Athena and Twilio work queues according to established priority rules
• Manage live and non-live triage requests, including member calls, portal messages, clinic requests, refill-related symptom concerns, and other routed clinical concerns
• Match calls and tasks to the correct Athena patient case; identify duplicate, incomplete, or misrouted cases
• Prioritize work based on clinical urgency, member safety risk, and approved workflow standards
• Conduct clinical assessments of member symptoms, history, current condition, and reported concerns
• Use approved triage protocols, clinical decision-support tools, and nursing judgment to determine appropriate care recommendations
• Confirm key member information including chief complaint, symptom onset, patient location, and callback number
• Identify red flags, worsening symptoms, high-risk presentations, or unclear clinical scenarios requiring escalation
• Determine appropriate triage outcomes: emergency care, same-day care, routine follow-up, home care guidance, or provider escalation
• Provide clear, understandable member education aligned with approved clinical protocols
• Communicate return precautions, safety-net instructions, and guidance for the appropriate care setting
• Direct members to the right resource — Emergency Department, Express Care, PCP visit, virtual visit, or follow-up appointment
• Support closed-loop follow-up to reduce missed handoffs and improve continuity of care
• Collaborate with clinic teams, providers, care management, and administrative support staff as needed
• Document triage encounters accurately and objectively in Athena using approved macros, workflow tags, and standardized fields
• Record clinical assessment findings, protocol used, triage disposition, member education provided, escalation actions, and follow-up steps
• Document unsuccessful contact attempts and unresolved safety concerns per approved workflow
• Escalate immediately for severe, worsening, or unclear symptoms; emergency symptoms or safety threats; members declining urgent care; unreachable members with urgent symptoms; and high-risk presentations including chest pain, shortness of breath, neurologic symptoms, severe bleeding, syncope, altered mental status, suicidal ideation, abuse, or neglect

Required Professional Skills & Experience

• Active, unencumbered Registered Nurse license in Texas or compact state privilege
• Minimum of 3–5 years of clinical nursing experience
• Experience in ambulatory care, primary care, urgent care, emergency department, telephone triage, or care coordination
• Strong clinical assessment, critical thinking, and prioritization skills
• Strong verbal and written communication skills
• Proficiency with EHR systems and basic computer skills
• Ability to remain calm, professional, and empathetic during urgent or high-pressure situations

Preferred Experience

• Experience with Athena, Twilio, ClearTriage, Schmitt-Thompson protocols, or centralized triage workflows
• Bilingual in English/Spanish, based on patient population needs
• Flexibility to support varied shifts, weekends, holidays, or after-hours workflows as needed